health midterm 4 Flashcards
what are the five defining features of the Canada health act
universality
comprehensiveness
accessibility
publicly administered on a nonprofit basis
portability
define universality
all eligible residents; uniform terms and conditions
define comprehensivness
must insure all medically necessary services provided by hospitals and physicians
define accessibility
must provide reasonable access to insured hospital and physician services without barriers
define publicly administered on a non profit basis
health insurance plan of a province must be administered and operated on a non-profit basis by a public authority accountable to the provincial government
residents are entitled to coverage move to another province within Canada
what are the responsibilities of healthcare and the role of the federal government
ensuring access to specific groups
First Nation and Inuit communities, RCMP, Correctional Services, Armed Forces, Veterans
Health protection
Health promotion, disease prevention, and education strategies
health research through funding provided to CIHI
financial support to the provinces through transfer payments
Only regulatory body that can ensure that health care is “portable” across the country
what is the role of provincial governments
Planning
managing
Delivery
true or false: healthcare is free
false
what type of health care system is in Canada
socialized healthcare system
general government revenue
how is our health care system financed
primarily through taxation
provincial, federal, personal, corporate income taxes
There isn’t a specific “health tax”
~70% of healthcare spending in Canada is paid for with dollars in the form of premiums collected through payroll deductions
some provinces use ancillary funding methods which are nominally targeted for health care - minor role:
Sales taxes
Payroll levies
Lottery proceeds
how much health care insurance does an average family pay
$17,713 for public health care insurance in 2024
what does the Ontario hospital services commission do
created the provincial premium in response to the need for improved hospital care in Ontario
who did the Ontario hospital services commission consult with
consulting with professional bodies such as the Canadian Medical Association and then making recommendations to the provincial government based on its findings
what does OHIP stand for
Ontario hospital insurance plan
what funds OHIP
public hospitalization insurance plan funded through compulsory premiums and provincial and federal contributions
how many Canadians are funded by OHIP
provided 91% of Ontarians with coverage that included hospital care for treatment of physical illness, mental illnesses and tuberculosis
what does OHIP not include
out patient diagnostic services or treatment
what are the steps in the health care system
pre hospital
hospitals- acute care settings
hospitals- chronic care/ rehabilitation
retirement homes/ homes for the aged
long term care/ nursing homes
what are some examples of pre hospital settings
family doctor
visiting nurses
walk in clinics
out patient lab/ x ray/ ultrasound
university health services
community care programs
911
what is a “hospital”
A hospital can be a(n):
source of essential healthcare
legal entity
employer
educator
laboratory
centre for diagnostic imaging
Research facility
what are the types of care in hospitals in Ontario
acute care
pediatric
mental health
chronic and complex care
rehabilitation
define acute care
generally involves short overnight stays for serious health problems
provide diagnostic, medical care and surgery for serious or life-threatening conditions such as a heart attack or stroke
age for admission is 18 years of age or older
define primary acute care
basic hospital care / ambulatory care / urgent care
widest scope of care
e.g., Stratford General Hospital
define secondary acute care
specialist heath care
referral from a primary care physician
the treating physician is not the first point of contact with the patient
define tertiary acute care
advanced medical investigation
requires highly specialized skills, technology and support services
e.g., London Health Sciences Centre, Hamilton General Hospital
define quaternary acute care
more specialized than tertiary
may involve experimental medicine and/or uncommon diagnostic or surgical procedures
very limited in number (none in Canada); usually a national health centre (i.e., CDC in the US)
define emergency care
- sub classified under acute care
- purpose is to treat life- threatening medical conditions to patients of all ages
- not all acute care hospitals will have emergency care
define pediatric care
- subclassified under acute care
- delivers care to children ages 0 to 17 years old
- hospitals for sick kids (Toronto) children hospital of eastern Ontario (CHEO)
define mental health care
primary role is to provide care for psychiatric disorders
often treat chronic conditions
what do general hospitals psychiatric units provide
assessment, stabilization and discharge planning for individuals who experience acute, severe psychiatric-related problems
specialty hospitals provide
more comprehensive care to individuals with more complex needs requiring longer lengths of stay
what is chronic care also referred to as
complex continuing care
what does chronic care include
provide continuing, medically complex and specialized services
to both young and old, sometimes over extended periods of time
a co- payment fee is required (like nursing homes)
CCC provides patients with room, board and other necesities in addition to medical care
define rehabilitation care
progressive, dynamic, goal-oriented and often time- limited process
enables an individual with an impairment to identify and reach his/her optimal mental, physical, cognitive and/or social functional level
what is a key component to rehabilitation care
the clients perspective
what are the 2 ways into an acute care setting
- emergency department
- direct admission
what are the two ways out of acute care settings
Discharged
community (back home)
chronic care / rehab care
retirement home
nursing home
Dealth
what are the trademarks of emergency care departments
Continual access to services
Time is of the essence
Unpredictable
how many emergency care visits are there in Ontario per year
6 million visits per year (…and growing)
what are some characteristics that lead to frequent ED users
Low SES
Smokers
Comorbid conditions (more than one disease conditions)
define triage
Obtain brief history from patient
rapid physical assessment including vital signs
Perform first aid if necessary
Determine severity ( acuity)
provide CTAS level based on assessment
transfer patient to another care area if necessary
what is canadian ED trade and acuity scales
implemented in 1998 as a means of prioritizing patients based on the acuity of their presentation
what types of care do paramedics provide
Primary Care
Advanced Care
Critical Care
what criteria do you need to meet to make your ambulance trip $45
If you are a resident of Ontario, AND
you have a valid Ontario Health Card, AND
a physician deems your ambulance service medically necessary, AND
your ambulance trip originates in Ontario and ends in Ontario…
define overcrowding
“a situation in which the demand for emergency services exceeds the ability of a department to provide quality care within acceptable time frames”
overcrowding is….
Chronic problem
systemic
Serious health issue
negative consequences
what are the causes of overcrowding
Lack of beds for patients admitted to the hospital
Shortage of nursing staff
increased complexity and acuity of patients in the ED
Increase in patient volumes
what happens due to overcrowding
Public safety at risk
prolonged pain and suffering
Long waits and patient dissatisfaction
Increased costs
ambulance diversions / off-load delay
violence
Decreased physician productivity
what are the proposed solutions to overcrowding
Increase the capacity to provide inpatient critical care and long term care beds
develop recruitment and retention initiatives for emergency physicians and nursing staff
encourage a further review of ambulance service provision (i.e., not everyone has to go to the ED)
Expand the scope of practice within ambulance communication centres
Informatics= data gathering and tracking
what is the difference between retirement care homes and long term care homes
retirement homes is for people who want to maintain their independence, with light assistance
long term care homes provide more extensive care and 24hr supervision
what is BILL 7
more beds, better care act
what does bill 7 allow
Bill 7 will allow hospitals to discharge ALC patients to LTC settings as they see fit….wherever that LTC setting may be
what is ALC
Alternate level of care (ALC)
patients who are occupying a bed in a hospital but do not require the intensity of resources provided in an acute care setting
historically referred to as “bed blockers”
what are some issues facing canadian hospitals
-long term care no beds
- increased wait times
- bed shortages
-ED overcrowding
- EMS
